Cervical hemilaminoplasty: technical note

Ten patients with cervical spinal schwannomas were operated using a new posterior approach, termed cervical hemilaminoplasty. A thread wire saw (T-saw) was used to cut the lamina at the center of the spinous process and at the unilateral pars interarticularis on the affected side. The unilateral lamina, the inferior articular process, and half of the spinous process were resected as a single mass. After tumor excision, the resected lamina was restored to the original site and fixed. Fusion technique was not required. The mean number of resected and restored lamina was 1.5. No instability of the cervical spine was detected using flexion/extension x-ray photography. Although worsening of radicular motor function was observed in 2 cases, the weakness was not permanent and both cases showed full recovery. Postoperative magnetic resonance imaging was performed in 7 of the 10 cases and showed no recurrences. Cervical hemilaminoplasty is a useful posterior approach method for spinal tumors and especially dumbbell-type tumors. This method provides wide exposure of the foramen and of the inside of the canal. Furthermore, it allows reconstruction of the posterior element of the spinal canal and results in good stability.